鼻咽癌患者放射治疗后大脑血液循环变化的连续监测  

The Measurement of Cerebral Blood Circulation Changes in Nasopharyngeal Carcinoma patients with Radiotherapy

作　　者：范秋虹[1] 毛卫东[1] 吴雪良[2] 刘春风[2] 

机构地区：[1]苏州大学附属第二医院放疗科 [2]苏州大学附属第二医院神经内科

出　　处：《中国血液流变学杂志》2003年第3期235-237,共3页Chinese Journal of Hemorheology

摘　　要：目的 对鼻咽癌(NPC)患者放射治疗前、后大脑血液循环的特征进行较长期的连续观察,以期为放射性脑损伤的早期诊断提供依据。方法 经颅超声多普勒对38例鼻咽癌患者在放疗前、放疗结束后、放疗后3个月和放疗后4年分别监测颈内动脉(ICA)、大脑中动脉(MCA)和基底动脉(BA)的血流速度,并进行自身对照。结果 本组患者鼻咽/颅底区域和上颈部的平均剂量为7472cGy和6752cGy,最后一次接受超声多普勒检查时间距离放射治疗结束48.4月。ICA流速几乎没有发生变化。MCA和BA在放疗结束后明显增高,其中MCA流速由53～54cm/s增高到59～60cm/s,最后回到57～58cm/s;BA的流速由放疗前30cm/s显著增加到35cm/s,放疗后4年仍达到34cm/s。结论 鼻咽癌放疗后MCA和BA流速增高提示面颈联合野照射时大脑动脉有痉挛性和/或狭窄改变,可能是脑缺血坏死的基础。Objective To detect the cerebral blood circulation changes in nasopharyngeal carcinoma patients after radiotherapy and to evaluate its value in the early diagnosis and treatment of radiation-induced brain damage. Methods At the beginning and the end of radiotherapy, three months and four years after the treatment, the blood flow velocity of intra-carotid artery (ICA), middle cerebral artery (MCA) and basal artery (BA) were measured by transcranial Doppler ultrasonography(TCD) respectively in 38 nasopharyngeal carcinoma patients,the flow velocity results in last three examinations were compared with Finding of the first time. Results The mean total dose of nasopharynx/skull base and upper-cervix regions were 7472 cGy and 6752 cGy, the duration between the beginning and last time TCD examination was 48. 8 months. The ICA velocity was stable from the beginning to the end. The velocity was raised from 53 - 54 cm/s before radiotherapy to 59 - 60 cm/s after radiotherapy. At last it returned to 57 - 58 cm/s; The BA velocity was about 30 cm/s before irradiation, it was significantly increased to 35 cm/s at the end of treatment and 34 cm/s at 4 years after the treatment . Conclusion The flow velocity of MCA and BA were increased significantly in nasopharyngeal carcinoma patients with radiotherapy. The result means that radiotherapy by brain and neck fields in NPC can induce spasm and/or narrow of lumens of MCA and BA. This maybe one of the causes of radiation-induced brain damage.

关 键 词：鼻咽癌 放射治疗 大脑 血液循环 连续监测 

分 类 号：R739.62[医药卫生—肿瘤]